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NCLEX - HURST REVIEW (Maternity) > Normal Post-partal Period > Flashcards

Normal Post-partal Period Flashcards

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1
Q

In the postpartum period the Temperature may raise to what and when ?

A

100.4 during the first 4 hours

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2
Q

What is the BP like in the postpartum period ?

A

Stable

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3
Q

A HR of what is common in the 6 to 10 days after a delivery ?

A

HR of 50 to 70 bpm

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4
Q

Tachycardia + Postpartum = ?

A

Think Hemorrhage

pregnancy = increased blood volume, so… should see less after birth

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5
Q

How are the Breasts postpartum ?

A

Soft for 2 to 3 days, then the dreaded engorgement occurs

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6
Q

What is the Abdomen like Postpartum ?

A

Soft/loose

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7
Q

Is hunger common in the mom in the postpartum period ?

A

Yes!

Can’t eat when in labor

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8
Q

What does FB stand for ?

A

Finger breadths

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9
Q

What is the fungus like in the postpartum period ?

A

The funds is midline 2 to 3 finger breadths (FB) below the umbilicus

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10
Q

Where is the fundus located a few hours after birth ?

A

It rises to the level of the umbilicus or to one FB above

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11
Q

What do you want the funds to be in the postpartum period ?

A

Firm***

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12
Q

What is the first thing you do if the Funds is boggy ?

A

massage the funds until it is firm and then check for bladder distention

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13
Q

In the Postpartum period, bladder distention is suspected when ?

A

When the uterus is above the expected level or is not in the midline
(usually moved to the right)

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14
Q

A distended bladder will not do what ? And increases the chance of what ?

A

Will not allow the uterus to contract normally

Which increases the chance of hemorrhage

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15
Q

Fundal height will decrease how ?

A

Will decent one finger breadth/day

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16
Q

What is the proper term used the the funds descends and the uterus returns to it’s pre-pregnancy size ?

A

Involution

if doesn’t happen, worry about hemorrhage

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17
Q

Afterpains are common when ? And will continue if what ?

A

For the first 2 to 3 days & will continue to be common if the mother chooses to breastfeed

(every time mom nurses, the body releases oxytocin which makes the uterus contract)

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18
Q

Rubra Lochia is seen when ? and is what color ?

A

3 to 4 days & is dark red

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19
Q

Serosa Lochia is seen when ? And is what color ?

A

4 to 10 days & is Pinkish brown

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20
Q

Alba Lochia is seen when ? And is what color ?

A

10 to 28 days (can be as long as 6 weeks) & is Whiteish yellow

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21
Q

You can have ________ Lochia up to 6 weeks ?

A

Alba

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22
Q

Clots are okay postpartum as long as they are what ?

A

No larger than a Nickel

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23
Q

Urine output:

After delivery, you should diuresis the excess fluid around when ?

A

Around 24 hours

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24
Q

Is Dehydration possible postpartum ?

A

Yes

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25
Q

Why should the legs be inspected so closely following delivery ?

A

For a DVT

26
Q

What are Tx’s for Perineal Care in the postpartum period ?

A
  • Intermittent ice packs for the first 24 hours (to decrease edema)
  • Warm water rinses
  • Sitz baths 2 to 4 times/day
  • Anesthetic sprays
  • Change pads frequently
  • Teach to report foul smell and any loch changes
27
Q

What is the Peripad rule in the Postpartum period ?

A

We do not want the client to saturate more than one peripad/hour

28
Q

Bonding with parents in the Postpartum period develops what ?

A

Trust in the infant

29
Q

In the infant, trust is not only an emotional need, but also a what ?

A

Physiologic need (Maslow’s)

30
Q

How does the Newborn benefit physiologically from bonding ?

A

Skin to skin contact

  • stabilizes HR
  • improves O2 stats
  • regulates the infants temp
  • Conserves calories
  • Breasts can change in temp to warm or cool the infant
31
Q

True or False:

The moms breast can change in temperature to warm or cool the infant ?

A

True

32
Q

Skin to skin contact is called what ?

A

Kangaroo care

33
Q

What is Kangaroo care & how is it done ?

A
  • Mom or dad places baby “skin to skin” on their chest
  • The baby is wrapped inside the parent’s shirt or covered with a blanket and held for 1 hour at least 3 times a week

(focus on premies, but now standard for all)

34
Q

How should the mom cleanse the breast after each feeding ?

A

With warm water & let air dry

35
Q

Should moms use a Support bra postpartum for Breast care ?

A

Yes

36
Q

can postpartum moms use ointment for breast soreness ?

A

Yes

37
Q

Breastfeeding moms should do what postpartum in relation to Breast care ?

A

Express some colostrum and let it dry

38
Q

Breast pads can be used Postpartum to do what ?

A

Absorb moisture

39
Q

What does the mother need to initiate ASAP after giving birth ?

A

Need to initiate breastfeeding ASAP after birth & alternate breasts

40
Q

If breastfeeding is interrupted, the mom can do what ?

A

Pump

41
Q

Moms should increase their caloric intake by what postpartum ?

A

By 500 calories/day

42
Q

The postpartum mother should have how much fluid/milk intake a day ?

A

Eight to ten 8 ounce glasses of fluid a day

43
Q

What is the goal of non-breastfeeding mothers ?

A

To decrease engorgement

44
Q

What are ways that Engorgement can be decreased in postpartum non-breastfeeding mothers ?

A
  • Ice packs
  • Breast binders (or ace wraps)
  • Chilled cabbage leaves
  • No stimulation of the breasts
45
Q

Why are chilled Cabbage leaves a Tx for decreasing engorgement in non-breastfeeding mothers ?

A

B/c chilled cabbage leaves decrease inflammation and decrease engorgement

46
Q

What are postpartum infections ?

A

Infections within 10 days after birth

E.coli, beta hemolytic strep

47
Q

What do you want to teach to moms to reduce postpartum infections after birth ?

A

Proper hygiene (front and back cleansing)

48
Q

For postpartum infections what do you usually get ?

A

Usually get cultures and Antibiotics

49
Q

What is early postpartum hemorrhage defined as ?

A

More than 500mL of blood lost in the first 24 hours accompanied by a 10% drop from admission hematocrit

(you must have both to be true! (dual definition) )

50
Q

What is late postpartum hemorrhage defined as ?

A

After 24 hours and up to 6 weeks postpartum

51
Q

What are causes of Postpartum Hemorrhage ?

A
  • Uterine atony (no tone = uterus will bleed)
  • Lacerations
  • Retained fragments and forceps delivery
52
Q

What can cause Uterine atony ?

A

A full bladder

53
Q

NCLEX TIP:

If get a OB question & don’t know the answer…. Pick Hemorrhage!!

A
54
Q

What are Medications used to Halt Excessive Postpartum Hemorrhage ?

A
  • Oxytocin (Pitocin)
  • Methylergonovine maleate (Methergine)
  • Carboprost tromethamine (Hemabate)
  • Misoprostol (cytotec)
55
Q

What can Mastitis be caused by ?

A

Poor hygiene or not feeding properly

56
Q

What is the major bacteria with Mastitis ?

A

Staphylococcus

57
Q

When does Mastitis usually occur ?

A

Around 2 to 4 weeks

58
Q

What are the signs and symptoms of Mastitis ?

A
  • Rapid onset of fever and chills
  • The breast will be swollen, hard, and tender to touch
  • Malaise
59
Q

What is the Treatment for Mastitis ?

A
  • Bed rest
  • Support bra
  • Binding and chilled cabbage leaves
    (are only to be used if breastfeeding is being discontinued permanently)
  • Initiate breastfeeding frequently or pump (if going to continue breastfeeding)
  • Penicillin (PCN)
  • Pain medications (depends on what it is and when you take it)
  • Heat (will cause breast to leak)
  • Feed baby frequently
  • Always offer the affected breast first
60
Q

How should Penicillin be taken for the Tx of Mastitis ?

A

Feed baby then take it

61
Q

What is the drug of choice for Mastitis ?

A

Penicillin

62
Q

What may be given alternatively in a mom with Mastitis who is allergic to penicillin ?

A

Eythromyacin

NCLEX - HURST REVIEW (Maternity) (10 decks)

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